When we think about digital health, we often imagine sophisticated telemedicine platforms, artificial intelligence, or expensive national digital strategies.

But what if digital health is already happening—without anyone officially planning it?

Our latest study, published in BMJ Public Health, explored how parents and healthcare providers in Punjab, Pakistan, are using WhatsApp for paediatric consultations.

What we found was remarkable.

WhatsApp is not simply being used as a messaging app. It has become an informal healthcare system. Parents send photos, videos, and voice messages. Doctors perform what we describe as "digital auscultation", remotely assessing children and deciding whether advice is sufficient or whether an in-person visit is necessary.

This system was never designed by governments. It emerged naturally because it solves real problems: distance, cost, limited access to healthcare, and the need for rapid medical advice.

But there is another side to the story.

The same system that improves access also creates new challenges: clinical uncertainty, privacy concerns, digital inequality, and an invisible workload for healthcare professionals who often remain available 24 hours a day.

Perhaps the most important lesson from our research is this:

Innovation does not always begin in ministries, universities, or technology companies. Sometimes it begins with patients and healthcare workers finding practical solutions to everyday problems.

At Salus Mundi, this is exactly how we believe digital health should be approached. Rather than replacing existing practices, we should first understand them. Rather than imposing technology, we should learn from the innovations that communities have already created.

The future of digital health will not be built only through new technologies.

It will be built by understanding how people actually use them.

Bernasconi A, Kirchhoffer H, Raza MT, et al. How are instant messaging applications used informally for paediatric health consultations in Pakistan? A qualitative study with caregivers and healthcare providers in Punjab. BMJ Public Health 2026;4:e004360. doi:10.1136/ bmjph-2025-004360